Over the past two decades, Romania's health system has made notable progress, reflected in increased life expectancy and significant reductions in infant and maternal mortality. Despite this progress, performance remains low relative to OECD countries in several areas, including health risk factors, access to healthcare, quality of services, healthcare capacity and financing. In response, Romania has implemented reforms to strengthen system efficiency and resilience, from enhancing health budgeting, to increasing remuneration for healthcare professionals, and the introduction of performance-based payment models. Persistent challenges remain to be addressed, notably in addressing wasteful health spending, workforce shortages, corruption, inefficiencies in primary and community healthcare, inadequate access to services, and fragmented health data systems. This review highlights Romania's ongoing efforts to improve sustainability, efficiency, quality, access, and resilience, providing policymakers and stakeholders with evidence-based insights to guide future reforms.
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